剪切波弹性成像新算法在乳腺结节诊断中的应用

发布时间：2018-04-01 19:30

本文选题：剪切波　切入点：新算法　出处：《郑州大学》2014年硕士论文

【摘要】：背景与目的剪切波弹性成像技术（shear wave elastography，SWE）是一种新的组织应变成像技术，作为一项直观、定量的超声检查新技术，SWE已广泛应用于乳腺结节良恶性的鉴别诊断。以往文献报道乳腺结节在弹性模式下二维面积与弹性面积的大小具有较大的差异，主要表现在弹性模式下恶性结节的弹性图面积大于二维图像，而良性结节时两者面积相近。因此得出不同性质的图像结节在弹性和二维声像图中面积有差异，成为鉴别乳腺结节良恶性的良好有力指标。本研究将通过SWE技术定量测量病变内部及周边区域的杨氏模量值，定量评价其在乳腺实性结节良恶性鉴别诊断中的价值。材料与方法采用SuperSonic Imagine AixPlorer型SWE超声诊断仪，应用实时剪切波弹性成像技术，测量56位患者89个乳腺结节内部杨氏模量平均值（Emean）、最大值（Emax）、标准差（SD）及结节周边的Emean（以结节二维面积的0.37倍腺体为结节周边部分），以病理结果为“金标准”，绘制ROC曲线，，判断其诊断价值。结果 ①良性组：结节内部Emean、Emax及SD分别为：（37.65±7.99）kPa、（81.82±12.78）kPa、（19.69±6.16）kPa，结节周边Emean为：（33.29±10.19）kPa，恶性组：结节内部Emean、Emax及SD分别为：（50.87±17.19）kPa、（114.26±30.02）kPa、（27.92±13.55）kPa，结节周边Emean为：（73.26±22.49）kPa.良恶性病灶结节内部Emean、Emax及SD差异均有统计学意义（P＜0.05）。良恶性结节周边Emean差异有统计学意义。 ②通过绘制ROC曲线，结节内部Emean、Emax及SD的曲线下面积（AUC）分别为0.736，0.855，0.734，临界点分别为：40.15kPa，90.5kPa，22.95kPa，结节周边Emean曲线下面积（AUC）为0.940，临界点为：44.55kPa。结论结节内部Emean、Emax及SD可为乳腺结节良、恶性的鉴别诊断提供依据，结节周边Emean的测量为乳腺结节良、恶性的鉴别提供了一种新的方法，优于结节内部Emean、Emax及SD。
[Abstract]:Background and purpose. Shear wave elastography is a new tissue strain imaging technique, which can be used as an intuitionistic method. The new quantitative ultrasound technique has been widely used in the differential diagnosis of benign and malignant breast nodules. The main manifestation is that the area of elastic image of malignant nodules is larger than that of two-dimensional images in elastic mode, but the area of benign nodules is the same. Therefore, it is concluded that there are differences in the areas of elastic and two-dimensional sonographic images of the nodules with different properties. This study will quantitatively measure the Young's modulus in the inner and peripheral areas of breast lesions by SWE technique and evaluate its value in the differential diagnosis of benign and malignant breast nodules. Materials and methods. Using SuperSonic Imagine AixPlorer SWE ultrasonic diagnostic instrument and real time shear wave elastic imaging technology, The average value of Young's modulus in 89 breast nodules was measured in 56 patients. The mean value of Young's modulus, the maximum value of Emaxus, and the standard deviation were measured. The ROC curves were plotted around the nodules by taking 0.37 times of the two-dimensional area of the nodules as the peripheral parts of the nodules, and using the pathological results as the "gold standard". To judge its diagnostic value. Results. 1 in the benign group, the mean Emax and SD in the inner nodule were 37.65 卤7.99kPa57.65 卤7.99kPa. the Emean around the nodule was 19.69 卤6.16kPa. the Emean around the nodule was 33.29 卤10.19kPa. in the malignant group, the EmeanEmax and SD were 50.87 卤17.19kPa114.26 卤30.02kPa27.92 卤13.55kPa. the Emean around the nodule was 73.26 卤22.49kPa.There were significant differences between the benign and malignant nodules (P < 0.05P < 0.05). The difference of Emean around nodules was statistically significant. 2 by drawing the ROC curve, the area under the curve of ROC and SD were 0.734, 0.736and 0.855kParespectively, the critical points were 40.15kPa90.5kPa-22.95kPa. the area under the Emean curve around the nodule was 0.940, and the critical point was: 44.55kPa. Conclusion. Emeanus Emax and SD can provide evidence for the differential diagnosis of benign and malignant breast nodules. The measurement of Emean around the nodules provides a new method for the differential diagnosis of benign and malignant breast nodules, which is superior to that within the nodules.
【学位授予单位】：郑州大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R445.1;R737.9

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